Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K31/00—Medicinal preparations containing organic active ingredients
  • A61K31/185—Acids; Anhydrides, halides or salts thereof, e.g. sulfur acids, imidic, hydrazonic or hydroximic acids
  • A61K31/19—Carboxylic acids, e.g. valproic acid
  • A61K31/195—Carboxylic acids, e.g. valproic acid having an amino group
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P25/00—Drugs for disorders of the nervous system
  • A61P25/04—Centrally acting analgesics, e.g. opioids
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P29/00—Non-central analgesic, antipyretic or antiinflammatory agents, e.g. antirheumatic agents; Non-steroidal antiinflammatory drugs [NSAID]

Definitions

• R ⁇ is hydrogen or a lower alkyl radical and n is 4, 5, or 6 are known in
• the instant invention is a pharmaceutical composition of synergistic effect which comprises a therapeutically effective amount of gabapentin or a pharmaceutically acceptable salt or hydrate thereof and therapeutically effective amount of pregabalin or a pharmaceutically acceptable salt or hydrate thereof.
• the pharmaceutical composition comprises gabapentin in the form of the free acid and pregabalin is in the form of the free acid.
• the pharmaceutical composition is gabapentin in a ratio of 1 : 1000 and pregabalin is from 1 : 1000.
• the pharmaceutical composition with a ratio of gabapentin to pregabalin from 1:1 to 1000:1 by weight.
• the preferred pharmaceutical composition with a ratio from 1 :1 to 250:1 by weight.
• the invention is also a method for the treatment of pain in a mammal in need thereof comprising administering a therapeutically effective amount of gabapentin or a pharmaceutically acceptable salt or hydrate thereof and a therapeutically effective amount of pregabalin or a pharmaceutically acceptable salt or hydrate thereof in unit dosage form.
• the method comprising administering gabapentin in the amount of from
• pregabalin in the amount of from 5 to 25 mg.
• the range of the types of pain is wide including chronic and acute types.
• Figures 1 and 2 show the effect of a fixed dose 1 : 1 ratio of gabapentin and pregabalin on the maintenance of CITH.
• Figures 3 and 4 show the effect of a fixed dose 10:1 ratio of gabapentin and pregabalin on the maintenance of CITH.
• Gabapentin is the generic name for the marketed product Neurontin®.
• the chemical name is 1 -(aminomethyl)-cyclohexaneacetic acid.
• the chemical structure of the compound is:
• Pregabalin is the generic name for (S)-3-(aminomethyl)-5-methylhexanoic acid.
• the chemical structure of the compound is:
• the present invention relates to pharmaceutical comparisons and methods of using them. These comparisons have a synergistic effect in the treatment of pain. Advantages of these compositions include fewer side effects as lower dosages are needed. This increases patient compliance with the beneficial result of better control of pain.
• the drugs can be administered together in the same dosage unit or can be prepared in separate dosage units administered at the same time. Different forms of dosage units can be used, i.e., a tablet of gabapentin and an injection of pregabalin.
• One particular advantage of the instant invention is the fact that no cross tolerance between the two compounds has been observed.
• the synergistic composition of this invention utilizes any GABA analogs.
• a GABA analog is a compound derived from or based upon gamma-amino- butyric acid.
• Thermal hyperalgesia was assessed using the rat plantar test (Ugo Basile, Italy) following a modified method of Hargreaves K., Dubner R., Brown F., Flores C, and Joris J., A new and sensitive method for measuring thermal nociception in cutaneous hyperalgesia, Pain 1988;32:77-88.
• Male Sprague-Dawley rats (70-90 g) were habituated to the apparatus which consisted of three individual perspex boxes on an elevated glass table.
• a mobile radiant heat source located under the table was focused onto the desired paw and withdrawal latencies (PWL) recorded. PWLs were taken 3 times for both hind paws of each animal, the mean of which represented baselines for right and left hind paws.
• Gabapentin and pregabalin were synthesised at Parke-Davis (Ann Arbor, USA). ⁇ -Carrageenan were obtained from Sigma (Poole, UK). All compounds were dissolved in water except carrageenan which was dissolved in isotonic saline. Gabapentin and pregabalin combinations were administered in the same solution. Drug administrations were made in a volume of 1 mL/kg.
• the figures show the synergy between gabapentin and pregabalin by comparing the theoretical addition and the synergetic responses.
• Dose response data for gabapentin and pregabalin alone (a).
• Fixed dose ratio of 1 : 1 gabapentimpregabalin combination (b).
• the theoretical additive line was calculated from the dose response data in (a). All compounds were administered P.O. and PWL to plantar test were examined 1-hour post drug administration. Results are expressed as mean PWL(s) (vertical bars represent ⁇ SEM).
• Acute pain is usually short-lived (e.g. postoperative pain).
• Chronic pain is usually defined as pain persisting from 3 to 6 months and includes somatogenic pains and psychogenic pains.
• Other types of pain are caused by injury or infection of peripheral sensory nerves. It includes, but is not limited to pain from peripheral nerve trauma, herpes virus infection, diabetes mellitus, causalgia, plexus avulsion, neuroma, limb amputation, and vasculitis.
• Neuropathic pain is also caused by nerve damage from chronic alcoholism, human immunodeficiency virus infection, hypothyroidism, uremia, or vitamin deficiencies.
• Psychogenic pain is that which occurs without an organic origin such as low back pain, atypical facial pain, and chronic headache.
• inflammatory pain osteoarthritic pain
• trigeminal neuralgia cancer pain
• diabetic neuropathy restless leg syndrome
• acute herpetic and postherpetic neuralgia causalgia
• brachial plexus avulsion occipital neuralgia
• gout phantom limb
• burn and other forms of neuralgia, neuropathic and idiopathic pain syndrome.
• the compounds of the present invention can be prepared and administered in a wide variety of oral and parenteral dosage forms.
• the compounds of the present invention can be administered by injection, that is, intravenously, intramuscularly, intracutaneously, subcutaneously, intraduodenally, or intraperitoneally.
• the compounds of the present invention can be administered by inhalation, for example, intranasally.
• the compounds of the present invention can be administered transdermally. It will be obvious to those skilled in the art that the following dosage forms may comprise as the active component, either a compound of Formula I or a corresponding pharmaceutically acceptable salt of a compound of Formula I.
• pharmaceutically acceptable carriers can be either solid or liquid.
• Solid form preparations include powders, tablets, pills, capsules, cachets, suppositories, and dispersible granules.
• a solid carrier can be one or more substances which may also act as diluents, flavoring agents, binders, preservatives, tablet disintegrating agents, or an encapsulating material.
• the carrier is a finely divided solid which is in a mixture with the finely divided active component.
• the active component is mixed with the carrier having the necessary binding properties in suitable proportions and compacted in the shape and size desired.
• the powders and tablets preferably contain from five or ten to about seventy percent of the active compound.
• Suitable carriers are magnesium carbonate, magnesium stearate, talc, sugar, lactose, pectin, dextrin, starch, gelatin, tragacanth, methylcellulose, sodium carboxymethylcellulose, a low melting wax, cocoa butter, and the like.
• the term "preparation" is intended to include the formulation of the active compound with encapsulating material as a carrier providing a capsule in which the active component with or without other carriers, is surrounded by a carrier, which is thus in association with it.
• cachets and lozenges are included. Tablets, powders, capsules, pills, cachets, and lozenges can be used as solid dosage forms suitable for oral administration.
• a low melting wax such as a mixture of fatty acid glycerides or cocoa butter
• the active component is dispersed homogeneously therein, as by stirring.
• the molten homogenous mixture is then poured into convenient sized molds, allowed to cool, and thereby to solidify.
• Liquid form preparations include solutions, suspensions, and emulsions, for example, water or water propylene glycol solutions.
• liquid preparations can be formulated in solution in aqueous polyethylene glycol solution.
• Aqueous solutions suitable for oral use can be prepared by dissolving the active component in water and adding suitable colorants, flavors, stabilizing and thickening agents as desired.
• Aqueous suspensions suitable for oral use can be made by dispersing the finely divided active component in water with viscous material, such as natural or synthetic gums, resins, methylcellulose, sodium carboxymethylcellulose, and other well-known suspending agents.
• viscous material such as natural or synthetic gums, resins, methylcellulose, sodium carboxymethylcellulose, and other well-known suspending agents.
• solid form preparations which are intended to be converted, shortly before use, to liquid form preparations for oral administration.
• liquid forms include solutions, suspensions, and emulsions.
• These preparations may contain, in addition to the active component, colorants, flavors, stabilizers, buffers, artificial and natural sweeteners, dispersants, thickeners, solubilizing agents, and the like.
• the pharmaceutical preparation is preferably in unit dosage form.
• the preparation is subdivided into unit doses containing appropriate quantities of the active component.
• the unit dosage form can be a packaged preparation, the package containing discrete quantities of preparation, such as packeted tablets, capsules, and powders in vials or ampoules.
• the unit dosage form can be a capsules, tablet, cachet, or lozenge itself, or it can be the appropriate number of any of these in packaged form.
• the quantity of active component in a unit dose preparation may be varied within wide limits. For practical purposes, it is present in a concentration of about 10% in a solid composition and about 2% in a primary liquid composition. In medical use the drug may be administered 1 to 3 times daily as, for example, as capsules.
• the composition can, if desired, also contain other compatible therapeutic agents.
• the compounds utilized in the pharmaceutical method of this invention are administered at the initial dosage of about 1 mg to about 1000 mg/kg daily.
• a daily dose range of about 1 mg to about 500 mg/kg is preferred.
• the dosages may be varied depending upon the requirements of the patient, the severity of the condition being treated, and the compound being employed. Determination of the proper dosage for a particular situation is within the skill of the art. Generally, treatment is initiated with smaller dosages which are less than the optimum dose of the compound. Thereafter, the dosage is increased by small increments until the optimum effect under the circumstances is reached. For convenience, the total daily dosage may be divided and administered in portions during the day, if desired.
• the relative amounts of the active ingredients in the combination may vary within a wide range.
• the synergistic combination may contain a ratio of about 1 : 1 to about 1000:1; preferably 1 :1 to 500:1 and particularly from 1 :1 to 250:1 parts by weight of gabapentin or a pharmaceutically acceptable salt or hydrate thereof to pregabalin or a pharmaceutically acceptable salt or hydrate thereof.
• the synergistic compositions of the instant invention are prepared by methods known in the pharmaceutical industry.
• the compositions may be prepared by admixing the active ingredient with inert, non-toxic carriers or diluents (e.g. cellulose, silicic acid, stearine, polyornyspyrsolidone, talc, starch, etc.).
• the compositions may also contain well known additives (e.g. emulsifying or suspending agents, dyes, salts for controlling the osmotic pressure, buffers, etc.)
• Lactose USP Anhydrous q.s. or 250 g
• Sterotex Powder HM 5 g Combine the compound and the lactose in a tumble blend for 2 minutes, blend for 1 minute with the intensifier bar, and then tumble blend again for 1 minute. A portion of the blend is then mixed with the Sterotex powder, passed though a #30 screen and added back to the remainder of the blend. The mixed ingredients are then blended for 1 minute, blended with the intensifier bar for 30 seconds, and tumble blended for an additional minute.
• the appropriately sized capsules are filled with 141 mg, 352.5 mg, or 705 mg of the blend, respectively, for the 50 mg, 125 mg and 250 mg containing capsules.
• Purified Water q.s. or 300 mL Combine the corn starch, the cellulose, and the compound together in a planetary mixer and mix for 2 minutes. Add the water to this combination and mix for one minute. The resulting mix is spread on trays and dried in a hot air oven at
• the compound or a suitable salt thereof is dissolved in water and passed through a 0.2-micron filter. Aliquots of the filtered solution are added to ampoules or vials, sealed and sterilized. Capsules
• Gabapentin or Pregabalin 100 mg, 300 mg, 400 mg, 600 mg Gabapentin: 100 mg and inactive ingredients gelatin and titanium dioxide

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• Health & Medical Sciences (AREA)
• Animal Behavior & Ethology (AREA)
• Public Health (AREA)
• Veterinary Medicine (AREA)
• General Health & Medical Sciences (AREA)
• Life Sciences & Earth Sciences (AREA)
• Medicinal Chemistry (AREA)
• Chemical & Material Sciences (AREA)
• Pharmacology & Pharmacy (AREA)
• Pain & Pain Management (AREA)
• General Chemical & Material Sciences (AREA)
• Chemical Kinetics & Catalysis (AREA)
• Organic Chemistry (AREA)
• Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
• Rheumatology (AREA)
• Neurosurgery (AREA)
• Engineering & Computer Science (AREA)
• Biomedical Technology (AREA)
• Bioinformatics & Cheminformatics (AREA)
• Epidemiology (AREA)
• Neurology (AREA)
• Acyclic And Carbocyclic Compounds In Medicinal Compositions (AREA)
• Pharmaceuticals Containing Other Organic And Inorganic Compounds (AREA)

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• 2000
  • 2000-06-21 EP EP00943001A patent/EP1196160B1/de not_active Expired - Lifetime
  • 2000-06-21 JP JP2001507475A patent/JP2003503453A/ja not_active Abandoned
  • 2000-06-21 DE DE60024995T patent/DE60024995T2/de not_active Expired - Fee Related
  • 2000-06-21 AT AT00943001T patent/ATE313322T1/de not_active IP Right Cessation
  • 2000-06-21 AU AU57539/00A patent/AU5753900A/en not_active Abandoned
  • 2000-06-21 ES ES00943001T patent/ES2255500T3/es not_active Expired - Lifetime
  • 2000-06-21 CA CA002373953A patent/CA2373953A1/en not_active Abandoned
  • 2000-06-21 BR BR0012058-8A patent/BR0012058A/pt not_active Application Discontinuation
  • 2000-06-21 MX MXPA02000170A patent/MXPA02000170A/es active IP Right Grant
  • 2000-06-21 WO PCT/US2000/017039 patent/WO2001001983A1/en active IP Right Grant
  • 2000-06-28 PE PE2000000651A patent/PE20010331A1/es not_active Application Discontinuation
  • 2000-06-30 UY UY26230A patent/UY26230A1/es not_active Application Discontinuation
  • 2000-06-30 AR ARP000103359A patent/AR030024A1/es unknown
  • 2000-06-30 CO CO00049385A patent/CO5210869A1/es not_active Application Discontinuation

Non-Patent Citations (1)

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